Forty Years in the Wilderness of Pills and Powders / Cogitations and Confessions of an Aged Physician

by William A. Alcott

Late in the evening,—or rather, in the night,—I arrived at the place, and found the young man still alive. He was, however, as it was easy to perceive, in a very critical condition. Glad to find him alive, but inclined to fall in with the general opinion that his case was a hopeless one, and withal greatly fatigued, I yielded to the demands of exhausted Nature, and slept a short time, when his physician arrived.

Now I had been sent for, in part, as a special friend, and in part, as a medical counsellor. And yet there were difficulties. Dr. Bolus, the family physician, was just such a man—for reasons that might be given—as I dreaded to advise with, should my advice be needed. He was one who would be likely to think any important suggestion an impeachment of his own superior wisdom. Science, true science, is always modest, and does not fear any thing; because she loves, most of all things, to be right. But Dr. Bolus had not, as I think, enough of true science to make him feel or perceive the want of it. The ignorant are always self-confident in proportion to their ignorance.

We examined the patient, as soon as possible, and retired for consultation. Dr. Bolus gave a full history of the progress of the case, with a particular account of the treatment. I saw at once, both from the existing symptoms and Dr. Bolus's statement, that the tendency to the brain—so great as to keep up an almost constant delirium—was quite as likely to be caused by the enormous quantities of morphine and quinine, and other active medicines which had been administered, as to belong properly to the disease. I therefore advised a gradual reduction and ultimate discontinuance of the extra stimulants.

Dr. Bolus was opposed to the reduction I proposed, but finally consented to it, at least in part, and the patient evidently derived almost immediate benefit from it. When I had pushed my views with regard to the stimuli as far as I could, we separated, and as the distance at which the doctor resided was considerable, and as I was on the spot to watch the patient, he proposed not to call again till early in the morning of the following day.

I was by no means satisfied with the compromise we had made. It had not accomplished its intended object. Dr. Bolus had, indeed, yielded a little, but not enough to satisfy me. I believed the amount of stimulus still given vastly too great, and was unwilling to continue it. In truth, I persuaded one of the attendants to omit the principal articles, whenever the hour came for administering them, assuring him that I would take all the responsibility.

Of the other attendant I would have made the same requisition, but he being exceedingly attached to Dr. Bolus, would never have tolerated the slightest concealment, or departure from the strictest letter of the law.

It was easy to see that the less stimulating treatment of each alternate two hours, during which it was entirely omitted, left behind it, on the patient's frame, a better influence than the more active treatment of the other two. And when the next medical consultation came, I pleaded for a still greater diminution of the stimulus. But, as I had unwillingly used a little duplicity,—a thing I now deeply regret,—in order to come at my conclusions against the stimulants, I was not willing to state, in full, the grounds of my opinion, and therefore could not prevail with Dr. Bolus to consent to any farther advances in the unstimulating plan.

I was now, at length, compelled to leave for home; and the results, for the rest of the time, were reported to me through the kindness of the young man's friends. It is sufficient, perhaps, to say that he finally recovered; but it was not till the lapse of several months. In the mean time, a severe ulcer broke out on the lower part of his back, which caused much suffering, and appeared to retard very greatly the progress of his recovery.

My errors in this case were numerous and great. Believing, as I did, in the outset, that Dr. Bolus and myself could never agree, I did wrong in consenting to a consultation with him. I ought to have been nothing but a visitor, or else to have entered fully into the spirit and duty of a counsellor. In the former case I might, indeed, have outraged every feeling of benevolence; in the latter I ought to have proposed my objections in full, and not to have compromised so as to submit to what I really believed to be radically and essentially wrong.

For I did most fully believe all this; and in spite of every effort at concealment, my scepticism finally came out, and I was weak enough to speak of it, and openly to find fault with Dr. Bolus. A practical quarrel followed between Dr. Bolus and myself, in which the friends joined, or, at least, strongly sympathized.